Organization
DIVERSITY COUNSELING ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAM OKANUME LCPC, LPC, MAC, LSWA (CEO)
(301) 814-3764
Entity
Organization
Contact information
Practice address
1300 MERCANTILE LN STE 129-17, LARGO, MD 20774-5327
(301) 814-3764
(240) 770-6916
Mailing address
14111 MARY BOWIE PKWY, UPPER MARLBORO, MD 20774-8572
(301) 814-3764
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129376100
—
MD
Enumeration date
03/18/2020
Last updated
03/18/2020
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